1. [Enhanced recovery after Caesarean delivery: a practice survey in two French regions].
- Author
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Wyniecki A, Raucoules-Aimé M, de Montblanc J, and Benhamou D
- Subjects
- Analgesics therapeutic use, Anesthesia Recovery Period, Anesthesia, Obstetrical methods, Anti-Inflammatory Agents, Non-Steroidal therapeutic use, Drinking, Enteral Nutrition, Female, France, Health Care Surveys, Hospitals, Maternity statistics & numerical data, Humans, Infant, Newborn, Interviews as Topic, Length of Stay, Oxytocin therapeutic use, Pain, Postoperative drug therapy, Patient Education as Topic, Perioperative Care standards, Postpartum Hemorrhage prevention & control, Pregnancy, Recovery of Function, Surveys and Questionnaires, Urinary Catheterization statistics & numerical data, Cesarean Section rehabilitation, Perioperative Care methods, Practice Patterns, Physicians' statistics & numerical data
- Abstract
Aims: Although most components of an enhanced recovery programme (ERP) can be applied to caesarean delivery, it is unknown if their implementation is large in France., Type of Study: Structured interview by telephone or e-mailing of an anaesthetist to describe usual perioperative practice in two French regions (Provence - Alpes - Côte d'Azur [PACA] and Île-de-France [IDF])., Methods: Questionnaire related to scheduled caesarean delivery., Results: Response rate 74% (111/149 maternity units). Multimodal analgesia was almost universally applied and intrathecal/epidural morphine used by 86% of respondents. Oral administration of analgesic drugs was started before h24 in 50% of responding units and immediately after delivery in 7% of them. The urinary catheter was withdrawn after h24 in 71% of responding centres. Women were allowed to drink between h4 and h6 (60%), in an unlimited amount (79%). The first meal was authorised after h6 (89%) but before h24 (65%) or after recovery of bowel function (13%). Oxytocin was used in 69% of respondents and maintained postoperatively for 12 to 24hours (70% of oxytocin users). Carbetocin was used in the remaining 31%, usually without any maintenance oxytocic drug. Attributing one point to each major component of the ERP protocol (0-6), the median value was 3 (2-4). An ERP protocol was available in 14% of responding units and was associated with a shorter duration of intravenous and urinary catheters use., Conclusion: The study shows that the components of an ERP are insufficiently implemented in France after caesarean delivery. Moreover, significant heterogeneity exists between maternity units and among regions., (Copyright © 2013. Published by Elsevier SAS.)
- Published
- 2013
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